目的 探讨脑电非线性动力学变化在抑郁症中的应用及抗抑郁药的疗效观察.方法 选取30例抑郁症患者,符合CCMD-3中国精神疾病诊断标准和汉密顿抑郁量表(HAMD)24项评分> 35分,同时选取30例健康者作为对照组;采集受试者安静闭眼状态下的脑电信号,分析抑郁症患者脑电非线性动力学参数关联维数(correlation dimension,D2)值的变化规律;分析抑郁症患者经抗抑郁药帕罗西汀治疗3周前后D2值变化规律.结果 安静闭眼状态下,抑郁组患者大脑皮质的大部分区域,如双侧前额、额部,右中央,左侧顶、枕、前颞、中颞,左、右后颞的D2值增高,与对照组比较,差异均有统计学意义(均P < 0.05);与治疗前比较,抑郁症患者经药物治疗3周后大脑皮质的部分区域,如左右前额、左前颞、右后颞的D2值降低,差异有统计学意义(P < 0.05).结论 抑郁症患者大部分脑区脑电信号D2值增高,治疗3周后部分脑区D2值降低,提示脑电非线性动力学分析可以客观地观测到抑郁症患者的大脑皮质电活动,可能成为一种客观评价抗抑郁药物治疗效果新的检测手段.%Objective To study the application of nonlinear dynamic analysis of EEG and to evaluate the effect of antidepressant on depressive patients. Methods The patients (n = 30) with depression were selected and evaluated by the classification and diagnostic criteria of the Chinese Mental Disorders-3 (CCMD-3) and HAMD-24 (score > 35), 30 health people were selected as control group. Electroencephalogram in closed eyes with a quiet state was collected, the changing laws of EEG non-linear parameters correlation dimension (D2) were selected and analyzed. The changing laws of D2 value after the treatment of Paroxetine were analyzed on depressive patients. Results D2 values in majority cerebral region PF1A1, PF2A2, F3A1, F4A2, C4A2, P3A1, O1A1, F7A1, T3A1, T5A1, T6A2 of depressive patients in closed eyes with a quiet state were found increased, the differences were all statistically significant (P < 0.05); D2 values in some cerebral region PF1A1, PF2A2, F7A1, T6A2 of depressive patients were found lower 3 weeks after the treatment than those of before the treatment, the differences were statistically significant (P < 0.05). Conclusion D2 values of correlation dimension in majority cerebral region increase in depressive patients, and decrease after treatment in some cerebral region. Nonlinear EEG analysis can objectively reflect the changes of cortical functional activity on patients with depression, monitor of EEG nonlinear may be a new technique to evaluate the effect of drug treatment on the depressive patients.
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